I've read what you wrote to David (male 22, just diagnosed positive). It brought me to tears. I am a hiv- male. No questions this time. Just wanted to say that you're really something. God bless you... Also wanted to tell you that I made a small donation. Thanks for being an instrument of perfect love (did that sound weird???).

Indonesia

Response from Dr. Frascino

Hello,

"An instrument of perfect love." No, that didn't wound weird. I just thought you were using a synonym for my being Italian.

Thanks for your thanks and your donation!

(I'll reprint the post you refer to below.)

Be well. Stay well!

Dr. Bob

Want to end this...

Jun 18, 2006

Dr Bob, how do you do it?

Just diagnosed positive, 22, male, girlfriend dumped me, parents don't want to know me, lost my job, took a bunch of pills, slit my wrist, best mate found me and took me to ER now a month later am still in hospital under suicide watch, psychiatrist won't release, really just writing in to hopefully get some words of wisdom you. I really respect and admire you. I have lost all my confidence. I feel I cannot go on.

How do you?

David.

Response from Dr. Frascino

Hello David,

How do I do it? How do I not slit my wrists? Hmmm . . . .

Well, to be honest, that thought is very foreign to me. Certainly living with HIV can, at times, be challenging. To claim otherwise would be ludicrous. However, in spite of those very significant challenges, I do not want to miss a single moment of my allotted time on this amazing planet. I treasure my very existence, each and every split second of it. I can find joy and pleasure in an unlimited array of activities listening to music, sipping coffee, getting wet sloppy kisses from either my dog or my lover, playing the piano, helping others who are less fortunate than I, etc., etc., etc. The list truly is endless.

HIV is no picnic. Girlfriends, parents and employers don't always behave as we would like. It's important to realize when they reject someone because of HIV, they are in essence rejecting the virus, not the person. Most of the time these rejections or bad behaviors stem from fear and ignorance of HIV/AIDS.

There is not doubt getting the news you are HIV positive is shocking. It changes everything. However, that things change does not mean things have to end. A period of adjustment to your new reality as a "virally enhanced" person is normal and to be expected. You my, at the moment, feel you cannot go on, but I can assure you those feelings are temporary. If I had committed suicide when I became infected in January of 1991, I would have missed the most amazing 15 years of my existence. I also would not be here responding to your question.

David, give yourself some time. Start to learn more about HIV/AIDS. A good place to begin is here at The Body. Try clicking on the Quick Links topics on The Body's homepage. Read through the information in the "Just Diagnosed" and "Inspiring Stories" chapters. Take control of your HIV; don't let it take control of you.

One mechanism I've found particularly helpful is to dedicate some of your time, energy and talent to help those in need. Volunteer at an AIDS service organization or spend some time at a pediatric cancer center or even an animal rescue center. Make your life matter. I'll leave you with one of my favorite quotes:

"This is the true joy in life, the being used for a purpose recognized by yourself as a mighty one. The being a force of nature instead of a feverish, selfish little clod of ailments and grievances complaining that the world will not devote itself to making you happy . . . . Life is no brief candle for me. It is a sort of splendid torch which I have got hold of for the moment, and I want to make it burn as brightly as possible before handing it on to future generations."

-- George Bernard Shaw

You will feel better, David. Start making plans for how to spend the rest of your life. The future is indeed yours, if you want it.

Dr. Bob

Response from Dr. Frascino

I'll also post a follow-up from David! See below.

Want to NOT end this...

Jul 1, 2006

Dear Dr Bob, I posted on June 18 a rather bleak outlook for my newly HIV positive life. I took your advice and now I feel great. I found comfort in reading the 'Just Diagnosed' section of this website.

My psychiatrist hooked me up with a paedeatric oncologist - I think that basically means a doctor who deals with children who have cancer. I was taken through the wards and all of a sudden my problems seemed completely insignificant.

My psychiatrist also hooked me up with a great HIV specialist doc - she really knows her stuff and was really supportive. My initial numbers indicate that I am 'progressing normally'. So far I don't require medicine and she said probably not for a while!!

I found a new employer and even ennrolled in college. My family is taking me on a trip to NYC as well and my girlfriend and I are back to talking.

I have realised that there is still a great deal I want to do with this life like travel, career, charity work, even have a family (my HIV doc says this is possible - though I don't see how if my semen is infected won't my child and / or wife be as well - please explain?).

I now feel as though there is not enough time on the planet rather than before when I dreaded every future moment with anxiety and a 'feel sorry for myself' attitude.

So thank you because you, at least in part, got me motivated enough to start this new 'virally enhanced' life!!!

Peace out - David.

Response from Dr. Frascino

Hey David!

Welcome back! Looks like you not only took my advice, but also that of Patti Labelle! Remember her song "New Attitude?"

"I'm feelin' good from my head to my shoes
Know where I'm goin' and I know what to do
I tidied up my point of view
I got a new attitude
Runnin' hot, runnin' cold
I was runnin' into overload
It was extremes, ex-ex-ex-ex-ex-extreme
It took it so high, so low So low,
there was nowhere to go
Like a dream Somehow the wires uncrossed,
the tables were turned
Never knew I had such a lesson to learn
I'm feelin' good from my head to my shoes . . . ."

And I think there are a lot of ooh, ooh, ooh, oohs in there as well . . . .

At any rate, I'm delighted with your new positive outlook on being positive!

As for the feasibility of your having a family, your HIV doctor is correct. With new sperm washing techniques coupled with in vitro fertilization, there is no reason why you should have to forgo the pleasures of fatherhood! I'll repost a question from the archives that addresses this topic.

Be well. Stay well, David!

Dr. Bob

HIV+ person wants children Mar 13, 2006

Hey Dr. Bob I have a client who found out recently that his boyfriend is HIV+. He asked me a question about the possibility of his boyfriend having children in the future. I told him that because it would probably be in vitro fertilization and a surrogate mother I couldn't see much risk of the child being +. Then I realized that I didn't really know what I was talking about so I decided to ask you. Can you clear this up for us? Health Educator in DC

Response from Dr. Frascino

Hi DC Health Educator,

The issue of HIV+ men wanting to conceive children safely and decrease the likelihood their mate or offspring will acquire the virus is a complex topic. I'll repeat a question from the archives that summarizes our current recommendations.

Dr. Bob

HIV + male HIV - female Feb 12, 2006

Dr. I have a question concerning having children. I have asked my HIV specialist and I am getting mixed answers. I am HIV pos and my wife is HIV neg. we really want to have a child, is it really possible to have a child without endangering her life and the child life. We decided against adoption and artificial reproduction (sperm banks). These were options to us. Is it really safe? Please give a yes or no answer if possible. I haven't received an answer.

Response from Dr. Frascino

Hello,

I'll repost a response form Dr. Sharon Lee below that addresses this problem.

Several people have written recently asking for information about sperm washing and their hopes about having a baby when the man is positive and the woman is negative. There are a growing number of places that provide information and that provide these services. Here is a comment and list of general resources:

Studies have suggested that HIV is not present in the sperm themselves but it is in the fluid which surrounds them (Semen). Sperm washing consists of removing the semen (and presumably the HIV) from the sperm and then using the "washed" sperm for insemination. There are currently three ways to attempt pregnancy using washed sperm. A common method used for years is intravaginal insemination, which involves holding a cervical cap full of live sperm near a woman's cervix and allowing them to swim into the uterus. Another is to directly insert the washed sperm into the uterus through a cannula (or plastic tube) placed through the cervix into the uterus. The safest method is in vitro fertilization, which only exposes the woman to fertilized eggs, and not to live sperm cells. In this technique the sperm cells and the egg are brought together in a laboratory and the fertilized eggs are implanted directly into the woman's uterus.

Sperm-washing combined was reported to be the source of one man passing the virus to his partner, though it remains unclear whether her infection was caused by the procedure. (A lawsuit is underway.) Health care professionals willing to undertake the sperm-washing venture are quick to remind their patients that it is only a risk-reduction method, and that no procedure is entirely risk-free. There are several places in the United States that utilize sperm washing. However, due to quite variable policies, you will need to contact fertility specialists in your individual area to find a doctor or to be referred.

2. Bay Area Perinatal AIDS Center (BAPAC), at the University of California, San Francisco's (UCSF) Positive Health Program in San Francisco General Hospital. Offers pre-conception counseling and infertility work-up to seroconcordant and discordant couples (both partners positive or one partner is positive). Also conducts prenatal care to HIV-positive women. Call (415) 206-8919. Visit http://php.ucsf.edu/bapac.

3. Center for Women's Reproductive Care, at Columbia University in New York City. Conducts IVF for serodiscordant couples. Call (646) 756-8282.

4. Duncan Holly Biomedical. Operates the Special Program of Assisted Reproduction (SPAR), started in 1994 as a support group for couples living with incurable sexually transmitted virus diseases such as HIV. Developed a mail-in product for shipping sperm-washed samples to fertility clinics around the country, as well as an HIV testing kit for sperm that can be mailed to you at home. Complete details and in-depth articles available on its Web site, including the story of Baby Ryan, the first baby conceived through SPAR. Call (781) 665-0750 or (617) 623-7447, or visit www.duncanholly.com/idi/spar/spar_main.html

8. Women Organized in Response to Life-Threatening Diseases (WORLD), 414 13th Street, 2nd floor, Oakland, CA 94612. Call (510) 986-0340. Visit www.womenhiv.org. Unfortunately, not all copies of their excellent newsletter and articles are available on-line. However, an abbreviated version of their article "Reducing the Risks of Conception: Getting Pregnant When One or Both Partners is HIV positive," is available at www.PositiveWords.com. The article is very easy to understand and extremely detailed.

To each of the couples who are concerned about this issue: our best wishes for wellness for you and your families!

Doc Can I be a daddy??? May 25, 2003

Hi Doctor Bob

I've been reading this board for over 2 months and I'd like to say i think... i mean I know you are one of theeeee smartest and wittiest Docs around to be honest most are quite the zzzzzzzzzzzzzzzz.

Anyhow... is it at all possible for a HIV POZ man to ever become a father without infecting the mother or the baby????

Thanks a billion and keep being YOU.

Response from Dr. Frascino

Hey possible future Dad,

I'm glad you don't find this forum a zzzzzzzzzzzz!

Is it possible for us positoids to be dads without infecting the mom or baby? Yes, it's possible, but it's not completely without risk. It involves a medical technique called "sperm washing." Now before you start thinking about having sex in your Maytag, let me explain. Using various techniques, sperm can be separated from the other fluids in cum. These other fluids carry the vast majority of HIV. The washed sperm is then used for artificial insemination or in-vitro fertilization. This technique drastically reduces the risk of HIV transmission. There are a variety of medical centers around the world studying this technique (Milan, Italy, for example). In the US, there are programs at Tufts University/New England Medical Center in Boston. Although it's a bit dated, check out the article in the Washington Post called "Seeking a Safe Path Toward Fatherhood." It can be found at http://washingtonpost.com/wp-dyn/articles/A99181-1999Apr18.html

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